Despite the relative novelty of apps, there is already a serious and substantial academic literature on their use in the treatment of mental health. Unfortunately, the academic orientation of much of this work makes it easy to overlook its practical benefits.
This post highlights some of the most interesting recent studies. It does not serve as a proper literature review or “meta-analysis.” Rather, it points out some important research and its relevance to the use and design of mental health apps.
1. Smartphones for Smarter Delivery of Mental Health Programs: A Systematic Review
This 2013 article, authored by several researchers at the Black Dog Institute at the University of New South Wales, attempted a large-scale survey of the literature on mental health app effectiveness. This proved difficult to do: of 5,464 abstracts, only 8 papers met the authors’ inclusion criteria. That sample did show evidence of effectiveness for mental health apps, but the small size of the sample limits confidence in that conclusion, as the authors note. As such, one of their main results is negative: “the majority of apps that are currently available lack scientific evidence about their efficacy.”
2. Patient Smartphone Ownership and Interest in Mobile Apps to Monitor Symptoms of Mental Health Conditions: A Survey in Four Geographically Distinct Psychiatric Clinics
This thoughtful 2014 study asks a simple question about mental health apps: do people with psychiatric conditions actually own smartphones, and are they interested in using mental health apps on them? It delivers a pleasingly positive answer: smartphone ownership is actually slightly higher among the target population, and most (70.6%) individuals are indeed interested in using smartphones to monitor their mental health.
3. mHealth for Mental Health: Integrating Smartphone Technology in Behavioral Healthcare
This widely-cited study is an overview of the state of the art in smartphone apps in mental health, circa 2011. It is especially useful for a listing of the smartphone apps available for various mental health purposes. This is an area of development that moves quickly, and 2011 is a long time ago by the standards of this area. Nonetheless, this early paper effectively and concisely describes some foundational issues that continue to drive current research.
4. A Systematic Review of Cognitive Behavioral Therapy and Behavioral Activation Apps for Depression
This review evaluates CBT and other apps available for download (circa 2016). It generally finds them wanting: just a little over 10% are found to be “consistent with evidence-based principles”. This tends to be a theme in academic research on apps. The authors conclude that “the application of superior scientific, technological, and legal knowledge is needed.” App developers might respond that if these researchers feel apps should be better, then they should develop better apps (or at least find the funding to do so).
5. Review and Evaluation of Mindfulness-Based iPhone Apps
This 2015 article evaluates meditation and other “mindfulness”-related apps avaialbe for the iPhone. This article uses the “Mobile Application Rating Scale” (introduced in this article) to rate meditation apps, with Headspace receiving the highest score. It concludes, however, that few apps rated highly and that “little evidence is available on the efficacy of the apps in developing mindfulness.”
There is a certain pessimism to the academic literature surveyed above. Though there is great interest in using apps to treat mental health – both by patients and practitioners – the apps that actually exist fall short of standards of academic rigor. As noted above, there is a certain lack of realism to some of these complaints: developing a high quality app requires significant technical and design skills, and it is in some ways easier to write an article criticizing existing apps than it is to actually design a better app. Nonetheless, this literature does advance the cause of mental health apps by establishing standards of rigor which some future apps may aim to meet.
Note: The contents of this post are for informational purposes only. This is not professional medical advice and it is not intended to be a substitute for professional medical advice. Always consult with a physician with any questions that you have about a medical condition, including a mental health condition. If you think you are in a medical emergency, call 911 or your local emergency services number immediately.